ah.thefinaldiagnosis-第33章

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　〃I　see；〃　Elizabeth　said　slowly。　〃And　you　mean　the　antibodies　would　start　fighting　with　the　baby's　blood…and　destroying　it。〃　She　had　it　now…clearly　in　her　mind。
　Dornberger　looked　at　her　admiringly。　This　is　one　smart　girl；　he　thought。　She　hadn't　missed　a　thing。　Aloud　he　said；　〃The　antibodies　might　destroy　the　baby's　blood…or　part　of　it…if　we　let　them。　That's　a　condition　we　call　Erythroblastosis　Foetalis。〃
　〃But　how　do　you　stop　it　happening？〃
　〃If　it　happens　we　can't　stop　it。　But　we　can　bat　it。　In　the　first　place；　as　soon　as　there　are　any　antibodies　in　the　mother's　blood　we　get　a　warning　through　a　blood…sensitization　test。　That　test　will　be　done　on　your　blood…now　and　later　during　your　pregnancy。〃
　〃How　is　it　done？〃　Elizabeth　asked。
　〃You're　quite　a　girl　with　the　questions。〃　The　obstetrician　smiled。　〃I　couldn't　tell　you　the　lab　procedure。　Your　husband　will　know　more　about　that　than　I　do。〃
　〃But　what　else　is　done？　For　the　baby；　I　mean。〃
　He　said　patiently；　〃The　most　important　thing　is　to　give　the　baby　an　exchange　transfusion　of　the　right　kind　of　blood　immediately　after　birth。　It's　usually　successful。〃　He　deliberately　avoided　mention　of　the　strong　danger　of　an　erythroblastotic　child　being　born　dead　or　that　physicians　often　induced　labor　several　weeks　early　to　give　the　child　a　better　chance　of　life。　In　any　case　he　felt　the　discussion　had　gone　far　enough。　He　decided　to　sum　it　up。
　〃I've　told　you　all　this；　Mrs。　Alexander；　because　I　thought　you　had　something　on　your　mind　about　Rh。　Also；　you're　an　intelligent　girl；　and　I　always　believe　it's　better　for　someone　to　know　all　the　truth　than　just　a　part　of　it。〃
　She　smiled　at　that。　She　guessed　she　really　was　intelligent。　After　all；　she　had　proved　she　still　possessed　her　old　classroom　ability　to　understand　and　memorize。　Then　she　told　herself：　Don't　be　smug；　besides；　it's　a　baby　you're　having；　not　an　end…of…semester　exam。
　Dr。　Dornberger　was　talking　again。　〃But　just　let　me　remind　you　of　the　important　things。〃　He　was　serious　now；　leaning　toward　her。　〃Point　one：　you　may　never　have　an　Rh…positive　baby；　either　now　or　later。　In　that　case　there　can't　be　any　problem。　Point　two：　even　if　your　baby　happens　to　be　Rh　positive；　you　may　not　bee　sensitized。　Point　three：　even　if　your　baby　were　to　have　erythroblastosis；　the　chances　of　treatment　and　recovery　are　favorable。〃　He　looked　at　her　directly。　〃Now…how　do　you　feel　about　it　all？〃
　Elizabeth　was　beaming。　She　had　been　treated　like　an　adult　and　it　felt　good。　〃Dr。　Dornberger；〃　she　said；　〃I　think　you're　wonderful。〃
　Amusedly　Dornberger　reached　for　his　pipe　and　began　to　fill　it。　〃Yes；〃　he　said；　〃sometimes　I　feel　that　way　too。〃
　
　〃Joe；　can　I　talk　to　you？〃
　Lucy　Grainger　had　been　on　her　way　to　Pathology　when　Pearson's　bulky　figure　loomed　ahead　in　the　main…floor　corridor。　As　she　called　to　him　he　stopped。
　〃Got　a　problem；　Lucy？〃　It　was　his　usual　catarrhal；　rumbling　voice；　but　she　was　glad　to　notice　there　was　no　unfriendliness。　She　hoped　she　was　still　immune　from　his　bad　temper。
　〃Yes；　Joe。　I'd　like　you　to　see　a　patient　of　mine。〃
　He　was　busy　lighting　one　of　the　inevitable　cigars。　When　he　had　it　going　he　surveyed　the　red　tip。　〃What's　the　trouble？〃
　〃It's　one　of　our　own　student　nurses。　A　girl　named　Vivian　Loburton。　She's　nineteen。　Do　you　know　her？〃
　Pearson　shook　his　head。　Lucy　went　on。　〃The　case　is　worrying　me　a　little。　I　suspect　a　bone　tumor　and　I've　a　biopsy　scheduled　for　the　day　after　tomorrow。　The　tissue　will　be　ing　down　to　you；　of　course；　but　I　thought　perhaps　you'd　like　to　take　a　look　at　the　girl。〃
　〃All　right。　Where　is　she？〃
　〃I've　had　her　admitted　for　observation；〃　Lucy　said。　〃She's　on　the　second　floor。　Could　you　see　her　now？〃
　Pearson　nodded。　〃Might　as　well。〃　They　moved　toward　the　main　vestibule　and　the　passenger　elevators。
　Lucy's　request　to　Pearson　was　not　unusual。　In　a　case　like　this；　where　malignancy　was　a　possibility；　it　was　the　pathologist　who　would　give　a　final　opinion　on　the　patient's　condition。　In　the　diagnosis　of　any　tumor　there　were　many　factors…sometimes　conflicting…for　a　pathologist　to　weigh　in　balance。　But　determination　of　bone　tumors　was　even　more　difficult；　something　of　which　Lucy　was　aware。　Consequently　it　was　an　advantage　for　the　pathologist　to　be　involved　with　a　case　at　the　beginning。　In　that　way　he　could　know　the　patient；　discuss　symptoms；　and　hear　the　radiologist's　opinion；　all　of　which　added　to　his　knowledge　and　aided　diagnosis。
　As　they　moved　into　the　elevator　Pearson　paused　and　winced。　He　put　a　hand　to　his　back。
　Lucy　pressed　the　button　for　the　second　floor。　As　the　automatic　doors　slid　closed　she　asked；　〃Is　your　back　bothering　you？〃
　〃Sometimes　it　does。〃　With　an　effort　he　straightened　up。　〃Probably　too　much　hunching　over　a　microscope。〃
　She　looked　at　him　concernedly。　〃Why　don't　you　e　to　my　office？　I'll　take　a　look　at　it。〃
　He　puffed　his　cigar；　then　grinned。　〃I'll　tell　you；　Lucy。　I　can't　afford　your　fees。〃
　The　doors　opened　and　they　went　out　on　the　second　floor。　Walking　down　the　corridor；　she　said；　〃It'll　be　plimentary。　I　don't　believe　in　charging　my　colleagues。〃
　He　gave　her　an　amused　glance。　〃You're　not　like　the　psychiatrists　then？〃
　〃No；　I'm　not。〃　She　laughed。　〃I　hear　they　send　you　a　bill；　even　if　you　work　in　the　same　office。〃
　〃That's　right。〃　She　had　seldom　seen　him　quite　so　relaxed　as　this。　〃They　say　it's　part　of　the　treatment。〃
　〃Here　we　are。〃　She　opened　a　door　and　Pearson　went　first。　Then　she　followed　him　in；　closing　the　door　behind　her。
　It　was　a　small　semi…private　room　with　two　patients。　Lucy　greeted　a　woman　in　the　bed　nearest　the　door；　then　moved　over　to　the　second　bed　where　Vivian　looked　up　from　the　magazine　she　had　been　reading。
　〃Vivian；　this　is　Dr。　Pearson。〃
　〃Hullo；　Vivian。〃　Pearson　said　it　absently　as　he　took　the　chart　which　Lucy　offered　him。
　She　answered　politely；　〃Good　afternoon；　Doctor。〃
　It　was　still　a　puzzle　to　Vivian　why　she　was　here　at　all。　Her　knee　had　been　paining　her　again；　it　was　true；　but　it　seemed　such　a　small　thing　to　be　put　to　bed　for。　However；　she　didn't　mind　very　much。　In　a　way　the　break　from　nursing…school　routine　was　wele；　and　it　was　pleasant　to　be　reading　and　resting　for　a　change。　Mike　had　just　phoned　too。　He　seemed　concerned　on　hearing　what　had　happened　and　had　promised　to　e　in　later；　as　soon　as　he　could。
　Lucy　drew　the　overhead　curtain　between　the　two　beds；　and　now　Pearson　said；　〃Let　me　see　both　knees；　please。〃
　Vivian　turned　back　the　bedclothes　and　lifted　the　hem　of　her　nightgown。　Pearson　put　down　the　chart　and　bent　over　for　a　close　inspection。
　Lucy　watched　the　pathologist's　short　stubby　fingers　move　carefully　over　the　limbs。　She　thought：　For　someone　who　can　be　so　rough　with　people　he's　surprisingly　gentle。　Once　Vivian　winced　as　a　finger　probed。　Pearson　looked　up。　〃Hurt　you　there；　eh？〃　Vivian　nodded。
　〃I　see　from　Dr。　Grainger's　report　that　you　hit　your　knee　about　five　months　ago；〃　he　said。
　〃Yes；　Doctor。〃　Vivian　was　being　careful　to　get　her　facts　straight。　〃I　didn't　remember　it　at　first…not　until　I　started　thinking　back。　I　hit　it　on　the　bottom　of　a　swimming　pool　though。　I　guess　I　dived　too　deeply。〃
　Pearson　asked　her；　〃Did　it　hurt　very　much　at　the　time？〃
　〃Yes。　But　then　the　pain　went　away　and　I　didn't　think　any　more　about　it…not　until　now。〃
　〃All　right；　Vivian。〃　He　gestured　to　Lucy；　who　pulled　the　bedclothes　back　into　place。
　He　asked　Lucy；　〃Have　you　got　the　X…rays？〃
　〃I　have　them　here。〃　She　produced　a　large　manila　envelope。　〃There　are　two　sets。　The　first　set　didn't　show　anything。　Then　we　softened　them　up　to　see　the　muscles；　and　that　showed　an　irregularity　in　the　bone。〃
　Vivian　listened　interestedly　to　the　exchange。　She　found　herself　experiencing　a　sense　of　importance　that　all　this　should　be　about　her。
　Now　Pearson　and　Lucy　had　moved　to　the　window　and　the　pathologist　held　the　X…ray　negatives　to　the　light。　As　he　studied　the　second　one　Lucy　pointed。　〃There。　You　see？〃　They　looked　at　it　together。
　〃I　guess　so。〃　Pearson　grunted　and　handed　back　the　negatives。　His　attitude　to　X…rays　was　always　that　of　one　specialist　groping　on　the　unfamiliar　territory　of　another。　He　said；　〃Shadows　from　shadow　land。　What　does　Radiology　say？〃
　〃Ralph　Bell　confirms　the　irregularity；〃　Lucy　answered。　〃But　he　can't　see　enough